Hamm K D, Steube D, Beer R, Pothe H
Abteilung Neurochirurgie, Medizinischen Akademie Erfurt.
Zentralbl Neurochir. 1987;48(3):206-18.
In a comparison of suture and fibrin bonding (using human plasma fraction Cohn I) direct as well as autologous and homologous nerve transplantations were performed in animal experiments. The study was carried out in a total of 66 Nn. ischiadici in Albino Wistar rats. With and without transplants the anastomoses were provided 26 times with the usual microsurgical single-button suture technique and 11 times tith a fibrin adhesive cuff with sequential application of the two components (500 I. U. thrombin/ml, 3,000 units contrycal) or simultaneous application after premixing of the components (5 I. U. thrombin/ml, 50 units contrycal). The qualitative evaluation was carried out after 4, 6, and 12 weeks according to the clinical and histological findings. With the use of sufficiently long transplants the nerve anastomoses could be fixed sutureless with the adhesive cuff more simply than with sutures. Histologically an undisturbed growing forth of the axons without foreign-body reactions and scarred constrictions could be proved. The sutured anastomoses, too, showed a good regeneration; owing to the 2-3 single button-sutures only low-degree tissue reactions occurred around the threads without any greater impairment of the proliferation of the neurites. In case of the direct uniting of the nerves adhesion was only possible in combination with a holding suture. In most cases, however, anastomose dehiscences with a bad result were nevertheless found. The direct nerve suture had to be carried out with 5-7 single-button sutures. In this case, considerably pronounced foreign-body reactions were sometimes found histologically. The nerve regeneration, however, was much better than in case of bonding by adhesion. In contrast to the application in direct nerve joining, the Cohn I adhesive could be used with good results for nerve transplantations.
在一项比较缝线与纤维蛋白黏合（使用人血浆组分科恩I）的研究中，在动物实验中进行了直接以及自体和同种异体神经移植。该研究总共在白化Wistar大鼠的66条坐骨神经上进行。在有和没有移植的情况下，吻合口分别26次采用常规显微外科单纽扣缝合技术，11次采用纤维蛋白黏合剂套袖，分两步依次应用两种成分（500国际单位凝血酶/毫升，3000单位抑肽酶）或在成分预混合后同时应用（5国际单位凝血酶/毫升，50单位抑肽酶）。根据临床和组织学结果，在4周、6周和12周后进行定性评估。使用足够长的移植神经时，用黏合剂套袖可以比用缝线更简单地进行无缝线固定神经吻合。组织学上可以证明轴突生长不受干扰，没有异物反应和瘢痕性狭窄。缝合的吻合口也显示出良好的再生；由于使用2 - 3根单纽扣缝线，缝线周围仅出现低度组织反应，对神经突增殖没有任何更大的损害。在神经直接对接的情况下，仅结合固定缝线才可能实现黏附。然而，在大多数情况下，仍发现吻合口裂开且结果不佳。直接神经缝合必须使用5 - 7根单纽扣缝线。在这种情况下，有时在组织学上会发现明显的异物反应。然而，神经再生比黏合连接的情况要好得多。与在直接神经连接中的应用不同，科恩I黏合剂用于神经移植可取得良好效果。
